6 Things Pediatricians Wish More Parents Knew

This past weekend, WhatToExpect.com was in Washington, D.C., for the American Academy of Pediatrics’ (AAP) annual meeting, where the nation’s pediatricians discussed the essential issues in children’s health today. From antibiotics to sofas, here’s six of the most important topics heard at the conference, along with what each means for your family.

1. There is no “alternate vaccine schedule”

From what diaper to buy to what baby food to choose, parents want the best for their kids. Unfortunately, there's a lot of misinformation regarding vaccines, which makes the issue a whole lot more confusing to navigate. That said, the research on the safety of vaccines is unequivocal. Since the first debunked study linking vaccines to autism was revoked and called “an elaborate fraud,” study after study has shown no link between MMR vaccine and autism, even in kids whose siblings have autism. Still, the topic of avoiding or delaying vaccines keeps coming up (most notably in a recent Republican debate)—which has led some parents, in turn, to ask for an alternate vaccine schedule.

What's more, many pediatricians may be giving in to these requests against their better judgment. A 2015 study in the journal Pediatrics found that of 222,628 infants in New York who had attended at least three vaccination visits by the age of 9 months, 69.3 percent stayed on the recommended vaccine schedule—which means nearly a quarter did not.

Another study in the same journal this year surveyed 534 pediatricians and found that 93 percent report some request of an alternate vaccine schedule, with 21 percent saying they receive the request in one in 10 patients. A whopping 87 percent, furthermore, admitted to delaying vaccines even though they believed that these parents were putting their kids at risk for disease, usually to “build trust with the families” and/or because they worried about parents leaving their practice.

Delaying vaccines, however, increases the risk that a child will be infected with a vaccine-preventable disease and puts the community at risk, too. The childhood vaccine schedule is recommended because it works—and the AAP is pleading with parents and pediatricians to stick to it.

2. Laundry pods are a poisonous kid-magnet

While laundry pods make cleaning your clothes simpler, the candy-colored products are attractive to kids, too: Toddlers love putting the pods their eyes or mouths. As a result, incidence of poisoning has been a growing problem since pods were introduced in 2012. A 2014 study in Pediatrics found that monthly exposures to pods exploded 645.3 percent between March 2012 and April 2013, with kids under the age of 3 accounting for nearly three quarters of all cases. The American Association of Poison Control Centers reports there were 11,714 incidents of poisoning from the pods, up from 10,395 in 2013.

The good news is campaigns have raised awareness that exposure to the pods can have serious consequences, including eye burns, vomiting, trouble breathing and loss of vision. While manufacturers have been doing their part in making their products less visually appealing to tots, parents can do their part to keep their little ones safe by always storing pods safely out of kids’ reach.

3. Babies and sofas don't mix

It likely seems harmless: You bring your baby to the couch to nap with you, or you nod off there while you’re breastfeeding your baby. But what some parents don’t realize is that sofas can pose a serious risk to young babies, since they can suffocate on soft cushions. A 2014 study in Pediatrics found that 12.9 percent of all sleep-related deaths happen on the sofa, most in babies under 3 months of age.

So if you’re especially tired, try to feed baby on a glider or chair instead of the sofa. And remember: The safest place for a baby to sleep is in her crib, on a flat and firm surface with no bumpers, blankets or plush toys.

4. Check food labels whenever possible

It can be hard if not downright impossible to know just what’s in that to-go salad or yogurt-and-granola cup unless you made it yourself. So there’s good reason nutritional information is on prepackaged products in the grocery store and on menu items at a growing number of fast food establishments around the country. They work!

In one recent survey, 823 parents were shown fast food menus without any nutritional information and with calories. Parents who saw menus without any nutritional info typically ordered 20 percent more calories for their kids than those who saw menus that displayed calories (1294 calories per meal for parents without any nutritional info vs. 1066 calories for parents who saw calories).

Of course this doesn’t mean you have to tick off the caloric count of everything you feed yourself and your child. But it does suggest that having nutritional info can definitely help you to make better decisions.

5. Antibiotics can do more harm than good, especially in first year of life

When your child isn’t feeling well, you’re likely looking for anything to help him feel better. But antibiotics—while definitely necessary in cases when bacteria is the culprit behind an illness (for example, a urinary tract infection)—can do more harm than good, say experts.

Researchers are just beginning to understand that antibiotics wipe out healthy bacteria in our bodies, which may change how our “microbiome”—the bacteria, fungi, viruses and other microbes that make up an estimated 90 percent of the human body—functions. Since the mircrobiome is thought to help regulate the immune system, overuse has been linked to an increased risk of a number of autoimmune diseases, including rheumatoid arthritis and inflammatory bowel disease (IBD).

Now, researchers have now found that kids who take antibiotics early in life are more likely to have juvenile idiopathic arthritis (JIA), which is most often caused by an autoimmune disorder. Study authors looked at 152 cases of JIA in kids ages 1 to 15 years old, excluding any children with known auto-immune disease (such as IBD), and found that those who had been given antibiotics in the past year were twice as likely to develop JIA compared to those who hadn’t—and those who had been given five courses of antibiotics were three times as likely to have JIA. It’s important to note that JIA is still very rare (and any link is not necessarily a causal relationship but a correlation—meaning it’s possible kids who required the antibiotics may have been more likely to have JIA to begin with).

Antibiotics may also change how our body breaks down and absorbs foods, which appears to increase a child's risk of being overweight or obese. A Finnish study published in 2015 in the journal Pediatrics looked at 6114 boys and 5948 girls between birth and 24 months and found that babies who were exposed to antibiotics in the first six months of life were significantly more likely to have an overweight BMI by the time they were 2 years old than kids who were not.

Another recent study in the International Journal ofObesity looked at the medical records of 163,820 kids ages 3 to 18 between 2001 and 2012 and found that one in five had received antibiotics seven or more times, and those kids weighed on average 3 pounds more than babies who had not been on antibiotics.

Bottom line: Try to trust your doctor when he says an antibiotic prescription for an infection where the drugs isn’t necessary (for example, for a viral infection like the cold/flu), since taking them may do your child more harm in both the short- and long-term than good. And if you think your doctor is prescribing an antibiotic when it isn't called for, don't be afraid to speak up and ask why one is necessary.

6. Introduce potentially allergenic foods early

Introduce peanuts early? Introduce them late? If you're not sure what the latest recommendations are, there's a good reason. For a long time, the recommendation was to avoid allergenic foods in the first year of life. But due to the growing rate of food allergies in recent years, experts are recognizing that introducing peanuts and other allergenic foods early might actually be the key to preventing allergies.

Today, more than 2 percent of all kids have a peanut allergy, up from 0.4 percent in 1997—a four-fold increase, said Robert Wood, MD, FAAP, in a presentation on diagnosing and treating food allergies. Given all of the media attention on the prevalence of food allergies, 25 percent of parents think kids have food allergy, when only 6 to 8 percent actually do, said Dr. Wood.

It turns out that avoiding peanuts early in life is likely at least partially to blame for increasing the rate of allergies, says Dr. Wood. A 2015 study published in the New England Journal of Medicine of more than 600 infants 4 to 11 months old who were most at risk for peanut allergies (because they had severe eczema and/or an egg allergy) either avoided peanuts or ate a peanut-containing food at least three times a week. Among kids who didn’t eat peanuts, 17 percent had developed an allergy by age 5, compared to 3 percent of those who regularly ate peanuts.

Studies like this have encouraged doctors, including the AAP this year, to change their recommendation on introducing allergenic foods. Dr. Wood says it appears the earlier peanuts and other allergenic foods are introduced into a child’s diet after starting solids, the better—and that eating peanuts for the first time “at 9 to 12 months is too late for most kids; by then you may lose the ability to prevent an allergy.”

If your child is at risk of a food allergy because an immediate family member has a food allergy, early introduction is an especially good idea. Just be sure to talk to your doctor first before serving that first nibble of peanut butter.